Overdose Fatalities Higher Than Predicted During Pandemic’s First Year

Drug overdose deaths increased significantly across the US during the first year of the COVID-19 pandemic, according to a study published online in PLOS Global Public Health.

“The third wave of drug overdose deaths began in 2013 with the arrival of fentanyl on the illicit drug market,” said study corresponding author Maria R. D’Orsogna, PhD, of the University of California at Los Angeles and California State University at Northridge, Los Angeles. “Although overdose deaths have steadily increased since then, the pandemic year 2020 saw a significant rise of fatalities in many states.”

Researchers analyzed trends in overdose deaths between 2013 and 2020 using mortality data from the National Vital Statistics System. The study zeroed in on overdose deaths by gender, race, and geography across four major drug categories: psychostimulants with addiction potential such as methamphetamines; heroin; prescription opioids; and synthetic opioids such as fentanyl and its derivatives.

In pandemic year 2020, increases in overdose deaths were significant in all drug categories except heroin, according to the study, and surpassed predictions based on trends from 2013 to 2019. Pandemic-related anxiety and a greater availability of cheaper drugs easily ordered online may have contributed to the rise in deaths, the authors believe.

The study also found that, beginning in 2018, overdose death rates for Black men and women exceeded those for White men and women for fentanyl and psychostimulants. In 2019 and 2020, the gap only widened.

“Perhaps most surprising to us were the results for the District of Columbia,” said researcher Lucas Böttcher, PhD, of the Frankfurt School of Finance and Management in Germany. “Here, the 2020 fentanyl-induced mortality was 134 deaths per 100,000 Black male residents but only 14 deaths per 100,000 White male residents. These disparities existed even prior to the pandemic, and are seen in other states as well, such as Illinois or Missouri.”

The analysis found high levels of heterogeneity in overdose death across various demographic groups. As a result, the authors recommend drug prevention strategies include racial, geographic, and gender-specific efforts to better target at-risk groups.

References

D’Orsogna MR, Böttcher L, Chou T. Fentanyl-driven acceleration of racial, gender and geographical disparities in drug overdose deaths in the United States. PLOS Glob Public Health. 2023;3(3):e0000769. doi:10.1371/journal.pgph.0000769

Racial disparities in US drug overdose fatalities significantly higher in 2020. News release. PLOS; March 22, 2023. Accessed September 13, 2023.